Total knee replacement

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Requested procedure: Total Knee replacement

WHAT EXACTLY IS TKR (TOTAL KNEE REPLACEMENT)?

A total knee replacement consists of a number of artificial components which replace the knee’s 3 articulations. Surgery in order to implant an artificial joint (a prosthesis) is generally considered once the pain and dysfunction caused by arthritis becomes too significant and is no longer treatable by means of medication alone. This procedure aims to improve your quality of life thanks to a knee that is ‘pain-free, stable and which boasts a functional range of movement’, enabling you to get on with your life, your career and sometimes even your sporting activities.

KNEE REPLACEMENT: THE PROCEDURE AND EXPECTED RESULTS

Patients will generally be in hospital for 5 to 7 days. Once they are back at home, the aim is to regain almost full knee function by gradually getting back to simple, everyday activities (at the start, this process will be supervised by a physiotherapist). More than 90% of patients who have undergone total knee replacement surgery can demonstrate satisfactory knee function 15 years after the operation, in other words, their knee allows them to undertake reasonable levels of activity and they can achieve more than 90 degrees of flexion (knee bend). Getting back to normal activities is a gradual process, but rehabilitation should take 6 to 12 months. The final objective is to achieve 125 degrees of knee bend by the end of the rehabilitation process, even if that depends on the knee bend befor the operation. However, it should be remembered that the knee replacement will not offer quite the same function as a normal knee and restitution ‘ad integrum’ (the restoration of complete knee function) is very unusual. In 60% of cases, the knee becomes entirely pain-free. In 30% of cases, pain periodically returns, often linked to changes in weather conditions. This pain is less acute than before and doesn’t require any kind of pain medication or management. Lastly, in 10% of cases, more significant pain is experienced, pain which may require some kind of medication or treatment. However, this does not mean that the prosthesis is not functioning correctly. A return to physical activities is possible after about 2 to 3 months following the procedure. Reasonable levels of activity may be undertaken. Golf, cycling, walking and swimming are sports that are recommended for people who have undertaken total knee replacement.

POTENTIAL RISKS AND COMPLICATIONS

All surgical procedures carry with them the potential for complications. The full list of possible complications may seem long, but it is important to remember that such complications are rare and generally-speaking, good results are achievable with this procedure. For the large majority of patients, the overall benefits significantly outweigh the extremely slight risk of unforeseeable medical complications. In addition to the risks associated with any procedure requiring the patient to be anaesthetized, there are some risks specifically associated with knee procedures: A hematoma may appear: this is a common occurrence which rarely requires surgical evacuation or a blood transfusion. The rate of infection for this procedure is 1 to 2%. Phlebitis is common (happening in 20 to 30% of knee replacement procedures) but much of the time it takes the form of ‘Superficial Venous Thrombosis’, which simply means the patient is prescribed a longer course of anticoagulants. Inflammation may cause pain and stiffness over a longer period of time (Complex Regional Pain Syndrome). For more information: http://www.nhs.uk/conditions/knee-replacement/Pages/Why-it-is-necessary.aspx

An extremely comfortable hospital where patient well-being and safety are unrivalled

This major hospital is perfectly-equipped to accommodate large numbers of patients in comfortable conditions thanks to its spacious (22,000 m²) facilities extending from the basement level to the fourth floor